The association of acute stroke and myocardial infarction in elderly medical emergencies

Summary

A retrospective study was made in an acute medical ward over 10 years. Patients 70 years and over who were admitted within 72 hours of the onset of an “acute stroke” were reviewed as to the possibility of a coexisting myocardial infarction. The latter diagnosis was based on clinical grounds (E.C.G. and enzyme elevation) and on autopsy reports.

In a series of 266 “acute strokes”, 30 (11.28%) were considered to have a coincidental cardiac infarction. Six of 31 autopsies (19.4%) showed unsuspected cardiac lesions. The mortality of the group was 76.6% inside 6 weeks. Recognition of the true incidence of cardiac infarction presenting as a stroke may require a large autopsy series. The problem seems generally underestimated and does not seem to have received the clinical recognition it deserves.